Health Financing in Singapore: A Case for Systemic Reforms

• Published in: International social security review (English edition) Vol. 59; no. 1; pp. 75 - 92
• Main Authors: Asher, Mukul G., Nandy, Amarendu
• Format: Journal Article
• Language: English
• Published: Oxford, UK and Boston, USA Blackwell Science Ltd 01.01.2006; Blackwell Publishing Ltd
• Subjects: Finance; Financial Support; Financing; Health care; Health care expenditures; Health Care Services; Health planning; Health policy; Health savings accounts; Public health; Regulatory reform; Singapore; Studies; Singapore
• ISSN: 0020-871X; 1468-246X
• DOI: 10.1111/j.1468-246X.2005.00234.x

This paper assesses Singapore's healthcare financing arrangements in terms of their efficiency, fairness, and adequacy. Singapore represents an interesting case study because it is perhaps the only high‐income, rapidly ageing country to rely on mandatory savings to finance healthcare, thus eschewing extensive risk‐pooling arrangements, generally regarded as efficient and equitable. The paper argues that parametric reforms, i.e. relatively minor changes in the parameters of current schemes which preserve the existing philosophy and system design, will not be sufficient to meet healthcare financing objectives. Systemic reforms, which will bring Singapore into the mainstream of health financing arrangements found in the OECD countries, are urgently needed. Their design and timing should be based on good quality, timely and relevant data, and an environment conducive to vigorous debate.